Housing and Mental Health Support for Exposure to Gun Violence

(TRUE HAVEN Trial)

Recruiting at 3 trial locations

Overseen By Emily Wang, MD, MAS

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Yale University

Disqualifiers: Plans to leave area

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

61770 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to assist individuals affected by gun violence by enhancing housing stability and mental health support. It offers financial assistance and education to those recently released from prison and their families, along with mental health training for community members. Individuals and families impacted by incarceration who reside in high gun violence neighborhoods in New Haven, Connecticut, may be eligible to participate. As an unphased trial, this study provides a unique opportunity to access supportive resources and contribute to community well-being.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this intervention is safe?

Research has shown that TRUE HAVEN aims to improve housing stability and provide mental health support. This program assists people who have been in jail and their families by creating a stable living environment and offering mental health support through community members trained in trauma counseling.

TRUE HAVEN differs from typical medical treatments by focusing on housing support and community training. Unlike new drugs, it has no reported side effects. Instead, it aims to assist with housing and mental health support, which are generally well-received.

This kind of support can positively impact mental well-being and community safety. No evidence suggests safety concerns related to the program itself. However, like any program, its success depends on effective implementation and community acceptance. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about TRUE HAVEN because it offers a holistic approach to addressing mental health challenges faced by those exposed to gun violence. Unlike traditional treatments that often focus solely on therapy or medication, TRUE HAVEN provides housing support and mental wellness training. This dual strategy not only addresses immediate physical needs but also empowers neighborhood residents with trauma-informed care skills. By tackling both environmental and psychological factors, this approach has the potential to create lasting change in communities affected by gun violence.

What evidence suggests that the TRUE HAVEN intervention is effective for reducing gun violence?

Research has shown that the TRUE HAVEN program, which participants in this trial may receive, aims to reduce community gun violence by improving housing stability and mental health support. The intervention arm of this trial includes housing support for recently incarcerated individuals and family members of currently incarcerated individuals, along with mental wellness training for neighborhood residents. Studies have found that financial assistance and housing education can significantly enhance the stability and well-being of families affected by incarceration. The program also trains community members in trauma-informed counseling, which has been linked to improved mental health for those exposed to violence. Early results suggest that combining these methods may create safer communities and more stable lives for participants. Although long-term data remains limited, these specific improvements indicate a promising strategy. ^{1 3 6 7 8}

Who Is on the Research Team?

Emily Wang, MD, MAS

Principal Investigator

Yale University

Are You a Good Fit for This Trial?

This trial is for residents in certain neighborhoods who have experienced gun violence. It's open to those re-entering society and their families, aiming to improve housing stability with financial aid and education. Mental health support is also provided through trained community counselors.

Inclusion Criteria

Family member currently incarcerated or person returning from prison within the last 12 months

Live in one of the six neighborhoods with highest rates of gun violence in New Haven, Connecticut

Exclusion Criteria

Plans to leave the study area within 1 year

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive housing support and mental wellness training for 6 months

6 months

Follow-up

Participants are monitored for changes in self-efficacy, gun violence rates, social cohesion, perceived health, and financial security

30 months

What Are the Treatments Tested in This Trial?

Interventions

• Name
• TRUE HAVEN

Trial Overview The 'TRUE HAVEN' intervention is being tested, which combines financial assistance for housing with educational support, as well as mental health services via a network of community members trained in trauma-informed counseling.

How Is the Trial Designed?

Group I: Intervention Experimental Treatment 1 Intervention

The two components in the intervention arm of TRUE HAVEN are: housing support for recently incarcerated people as well as family members of currently incarcerated people, and mental wellness training for neighborhood residents to participate in trauma-informed care training sessions.

Group II: Control Active Control 1 Intervention

TRUE HAVEN is already approved in United States for the following indications:

Approved in United States as TRUE HAVEN for:

• Gun violence prevention
• Community resilience building

Who Is Running the Clinical Trial?

Yale University

Lead Sponsor

Trials

1,963

Recruited

3,046,000+

National Institute on Minority Health and Health Disparities (NIMHD)

Collaborator

Trials

473

Recruited

1,374,000+

Published Research Related to This Trial

In a study of 237 participants experiencing homelessness and serious mental illness, supportive housing was linked to significantly better overall health outcomes, with participants showing three times the odds of reporting good to excellent health after 6 months.

Supportive housing also contributed to reduced psychological distress over time, highlighting its effectiveness as a health intervention in improving mental health and quality of life for individuals in diverse backgrounds.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A longitudinal analysis of peer-delivered permanent supportive housing: Impact of housing on mental and overall health in an ethnically diverse population. Crisanti, AS., Duran, D., Greene, RN., et al.[2022]

Community-led solutions, such as promoting role models and enhancing social cohesion, are essential for preventing gun violence in communities of color, as identified through interviews with 45 individuals in New Haven, CT.

Investing in stable housing, community-based mental health services, and youth activities can significantly help reduce the factors contributing to gun violence in these neighborhoods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

"We know what's going on in our community": A qualitative analysis identifying community assets that deter gun violence. Parsons, A., Harvey, TD., Andrade, SD., et al.[2023]

Gun violence rates have increased during the COVID-19 pandemic due to factors like social isolation and economic instability, particularly affecting marginalized communities.

Hospital-based violence intervention programs (HVIPs) are essential for reducing repeat violent injuries, but the pandemic has created significant barriers to their effectiveness, necessitating adaptations in service delivery to better support participants.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploring emergent barriers to hospital-based violence intervention programming during the COVID-19 pandemic. Wical, W., Harfouche, M., Lovelady, N., et al.[2023]

In a survey of 1,189 residents from low-income neighborhoods in New Haven, Connecticut, 73% reported hearing gunshots, and significant numbers had personal connections to gun violence, with 29% having family or friends harmed and 18% killed.

The study highlighted that exposure to gun violence is disproportionately higher among residents of color, particularly young Black men aged 18 to 34, emphasizing the need for a public health approach that addresses both mass shootings and urban violence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Bridging the Response to Mass Shootings and Urban Violence: Exposure to Violence in New Haven, Connecticut. Santilli, A., O'Connor Duffany, K., Carroll-Scott, A., et al.[2022]

The TRUE HAVEN study is designed to reduce community gun violence in New Haven by providing stable housing and financial education to individuals affected by incarceration, with interventions implemented in six high-violence neighborhoods over staggered six-month periods.

The study incorporates trauma-informed counseling and policy changes to combat structural racism, aiming to create a comprehensive approach that not only addresses immediate needs but also fosters long-term community stability and well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

TRUsted rEsidents and Housing Assistance to decrease Violence Exposure in New Haven (TRUE HAVEN): A strengths-based and community-driven stepped-wedge intervention to reduce gun violence. Tong, G., Spell, VT., Horton, N., et al.[2023]

The TRUE HAVEN study is designed to reduce community gun violence in New Haven, Connecticut, by providing stable housing and financial education to individuals affected by incarceration, with a focus on neighborhoods with high gun violence rates.

This multi-level intervention includes trauma-informed counseling and policy changes to combat structural racism, aiming to foster community stability and well-being, with the primary outcome being the neighborhood rate of gun violence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Trusted residents and housing assistance to decrease violence exposure in New Haven (TRUE HAVEN): a strengths-based and community-driven stepped-wedge intervention to reduce gun violence. Tong, G., Spell, VT., Horton, N., et al.[2023]

Only a small percentage of individuals with mental illness are at risk for extreme violence, and they contribute to a minor fraction of gun-related homicides, highlighting the complexity of gun violence as a public health issue.

The authors recommend that Connecticut physicians advocate for securing guns in homes with children and consider voluntary removal of firearms from homes with individuals at risk for violence or with untreated major mental illnesses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Gun Violence, mental health, and Connecticut physicians. Dodds, PR., Anderson, CO., Dodds, JH.[2015]

The Project Safe Neighborhoods: Dallas initiative did not lead to a reduction in violent crime rates in the target areas, which remained higher than non-target areas, and even showed a non-significant increase after its launch in April 2018.

Rates of patients presenting with firearm and assaultive injuries nearly doubled within two years of the initiative, indicating that the program may have been ineffective in reducing violence and that offenders might have relocated to avoid increased law enforcement scrutiny.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safer neighborhoods? Violent crime and trauma volume pre/post targeted police interventions in Dallas, Texas. Roden-Foreman, JW., Pettigrew, M., Edmundson, PM., et al.[2023]

Supportive housing, particularly the 'housing first' model, is the leading approach in the U.S. for helping chronically homeless individuals achieve housing stability and improved health, but the implementation of this model varies significantly across programs.

Qualitative interviews in Chicago revealed six distinct types of supportive housing based on housing configuration and service models, highlighting the need for comparative effectiveness research to determine which combinations of components yield the best health outcomes for different homeless subpopulations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Identifying variability in permanent supportive housing: A comparative effectiveness approach to measuring health outcomes. Dickson-Gomez, J., Quinn, K., Bendixen, A., et al.[2022]

Permanent supportive housing programs with case management support significantly help homeless individuals with mental illness, as most participants remained housed for at least one year compared to those in control groups.

Despite these positive outcomes, the review identified significant limitations in the studies, such as biases and inconsistent definitions of housing programs, which hinder the ability to draw strong conclusions for policy-making.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Housing Programs for Homeless Individuals With Mental Illness: Effects on Housing and Mental Health Outcomes. Benston, EA.[2022]

Citations

1. bmcpublichealth.biomedcentral.com bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-15997-x

Trusted residents and housing assistance to decrease ... TRUE HAVEN aims to lower rates of community gun violence by fostering the stability, wealth, and well-being of individuals and families directly impacted by ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10426138/

Trusted residents and housing assistance to decrease ... TRUE HAVEN aims to lower rates of community gun violence by fostering the stability, wealth, and well-being of individuals and families directly impacted by ...

3. clinicaltrials.gov clinicaltrials.gov/study/NCT05723614

TRUsted rEsidents and Housing Assistance to Decrease ... The overall objective of this study is to implement and test a strengths-based, community-driven intervention to reduce gun violence by (1) improving ...

4. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/37214890/

TRUsted rEsidents and Housing Assistance to decrease ... TRUE HAVEN aims to lower rates of community gun violence by fostering the stability, wealth, and well-being of individuals and families directly ...

5. clinicaltrial.be clinicaltrial.be/en/details/263252?per_page=20&only_recruiting=0&only_eligible=0&only_active=0

TRUsted rEsidents and Housing Assistance to Decrease Viol... The two components of the TRUE HAVEN intervention are: housing support for recently incarcerated people as well as family members of currently incarcerated ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10197755/

A strengths-based and community-driven stepped-wedge ... TRUE HAVEN aims to reduce gun violence by providing housing, financial education, trauma-informed counseling, and policy changes to address structural racism.

7. researchgate.net researchgate.net/publication/373115969_Trusted_residents_and_housing_assistance_to_decrease_violence_exposure_in_New_Haven_TRUE_HAVEN_a_strengths-based_and_community-driven_stepped-wedge_intervention_to_reduce_gun_violence

Trusted residents and housing assistance to decrease ... TRUE HAVEN aims to lower rates of community gun violence by fostering the stability, wealth, and well-being of individuals and families directly impacted by ...

8. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/37580653/

Trusted residents and housing assistance to decrease ... TRUE HAVEN aims to lower rates of community gun violence by fostering the stability, wealth, and well-being of individuals and families directly impacted by ...